How much does Medicare pay for CPT 72195?

Medicare allowed an average of $147.56 per service and paid $112.95 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1009.08, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 72195?

Mri scan of pelvis without contrast. It was billed 50,629 times to 48,233 Medicare beneficiaries by 1,957 providers in 2024.

Does 72195 pay differently in an office than a hospital?

Yes. The allowed amount averaged $180.21 in an office setting and $67.69 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 72195 most?

Diagnostic Radiology, with 42,512 services from 1,645 clinicians. Next are Independent Diagnostic Testing Facility (IDTF), Orthopedic Surgery, Urology.

CPT 72195

Mri scan of pelvis without contrast

$147.56Medicare-allowed amount per service, averaged across 50,629 services

Providers submitted

$1009.08

Asking price, not received

Medicare allowed

$147.56

The fee schedule figure

Medicare paid

$112.95

Balance is patient coinsurance

Providers submitted an average of $1009.08 for this code and Medicare allowed $147.56 — 6.8× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $112.95 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $180.21
Hospital / facility: $67.69

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 35,937 services were billed in an office setting and 14,692 in a facility.

Services: 50,629
Beneficiaries: 48,233
Providers billing it: 1,957
Total allowed: $7,470,815

What Medicare pays for CPT 72195

Across 50,629 services billed by 1,957 providers to 48,233 beneficiaries, Medicare allowed an average of $147.56 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 72195

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	42,512	40,681	$139.02	1,645
Independent Diagnostic Testing Facility (IDTF)	5,470	5,282	$208.57	199
Orthopedic Surgery	601	566	$185.22	25
Urology	543	336	$116.37	18
Physical Medicine and Rehabilitation	272	266	$175.93	17
Radiation Oncology	245	166	$169.56	8
Interventional Radiology	190	189	$107.62	10
Nuclear Medicine	161	142	$140.62	5
Physician Assistant	127	127	$167.90	4
Anesthesiology	88	77	$194.00	5
Nurse Practitioner	73	73	$151.82	2
Neurosurgery	66	63	$241.94	2
Pain Management	60	44	$142.72	3
Undefined Physician type	52	52	$121.00	3
Rheumatology	31	31	$162.98	2

72195 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	7,050	$144.53	$94.73	172
California	6,632	$180.00	$119.04	256
Florida	5,827	$166.51	$127.58	205
Texas	3,920	$160.50	$124.99	173
Ohio	1,850	$130.35	$98.82	47
Virginia	1,724	$140.09	$98.18	59
Illinois	1,618	$115.91	$87.56	67
Arizona	1,566	$151.19	$116.32	63
Maryland	1,446	$187.18	$131.02	59
Arkansas	1,380	$67.34	$55.65	26
Massachusetts	1,322	$145.13	$99.26	54
Missouri	1,120	$125.90	$96.19	47
New Jersey	1,098	$208.86	$142.59	53
North Carolina	997	$104.85	$83.33	56
Minnesota	984	$165.70	$121.95	51
Washington	960	$129.52	$90.87	44
Tennessee	919	$102.71	$83.81	39
Pennsylvania	914	$127.14	$95.87	43
Colorado	904	$165.89	$116.87	38
Georgia	837	$115.18	$86.25	43
Indiana	633	$88.88	$69.92	32
Michigan	579	$116.87	$88.15	29
South Carolina	551	$143.36	$115.62	23
Oklahoma	443	$138.81	$111.36	22
Kansas	443	$123.17	$96.92	22
Alabama	441	$144.72	$120.75	20
Delaware	431	$118.83	$85.76	13
Louisiana	427	$144.25	$117.79	17
Nevada	365	$210.62	$163.47	16
Connecticut	290	$167.94	$117.96	14
Utah	277	$145.95	$118.11	17
Nebraska	269	$150.04	$122.30	14
Mississippi	266	$135.00	$115.66	15
Oregon	264	$109.51	$82.38	11
New Hampshire	233	$78.10	$57.89	11
Wisconsin	212	$69.63	$50.72	15
Idaho	208	$91.82	$72.68	10
Kentucky	204	$117.18	$98.14	9
Iowa	186	$100.60	$78.07	9
District of Columbia	173	$162.44	$115.01	6
New Mexico	118	$128.88	$97.53	6
Rhode Island	89	$166.53	$115.49	5
Hawaii	85	$214.17	$139.35	3
Alaska	60	$184.55	$121.16	3
West Virginia	48	$65.88	$49.10	4
Puerto Rico	41	$74.04	$56.20	1
Maine	38	$138.45	$111.54	3
Vermont	37	$111.52	$85.86	3
North Dakota	32	$63.65	$50.94	2
South Dakota	31	$67.70	$45.30	2
AP	31	$67.77	$47.14	1
Montana	29	$65.94	$51.30	2
Wyoming	27	$163.19	$122.85	2

Related codes

72125Ct scan of upper spine without contrast$46.99
72100X-ray of lower and sacral spine$23.76
72148Mri scan of lower spinal canal without contrast$116.92
72110X-ray of lower and sacral spine$34.78
72170X-ray of pelvis$13.01
72141Mri scan of upper spinal canal without contrast$108.96
72131Ct scan of lower spine without contrast$53.06
72197Mri scan of pelvis before and after contrast$191.31
72146Mri scan of middle spinal canal without contrast$99.42
72128Ct scan of middle spine without contrast$46.63
72158Mri scan of lower spinal canal before and after contrast$149.73
72192Ct scan of pelvis without contrast$53.35

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.